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Effect of internal limiting membrane peeling on visual field sensitivity in eyes with epiretinal membrane accompanied by glaucoma with hemifield defect and myopia



To investigate the effects of internal limiting membrane (ILM) peeling on visual field sensitivities in eyes with epiretinal membrane (ERM) accompanied by glaucoma with hemifield defect and myopia.

Study design

Retrospective clinical study


We reviewed clinical records of patients with ERM who underwent vitrectomy and ERM/ILM peeling. We first collected clinical data of eyes with ERM and glaucoma with hemifield defect. We recorded visual field sensitivities at 52 points and analyzed differences between before and after surgery. We then compared the changes in visual field sensitivity between glaucomatous and normal hemifields. Next, we collected ERM eyes without glaucoma and stratified them into two groups based on axial length (threshold = 26.0 mm). In these eyes, we also recorded visual field sensitivities at 52 points and analyzed differences between before and after surgery.


The study included 18 eyes with ERM and glaucoma with hemifield defect (11 men; mean age, 68.3 ± 7.2 years). These eyes showed significant sensitivity reductions at 5/26 points, mainly in the nasal area of the glaucomatous hemifield, whereas only 1/26 points exhibited significant sensitivity reduction in the normal hemifield. In eyes with axial length <26.0 mm and axial length ≥26.0 mm, 29 peripheral and seven superior peripheral points showed significant improvements in visual field sensitivities, respectively.


Visual field sensitivity reduction occurred mainly in the nasal region of the glaucomatous hemifield. Differences in axial length alone were not a prominent risk factor for reduced visual field sensitivity after ILM peeling in eyes with ERM.

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The authors thank Drs. Shu Kachi, Tadasu Sugita, Ayana Suzumura, Rina Namba, and Kazuhisa Yamada for their important clinical suggestions and Ms. Kumi Fujiwara, Mr. Keigo Omori, and Ms. Waka Miyagi for technical assistance. The authors also thank Ryan Chastain-Gross, Ph.D., from Edanz Group ( for editing a draft of this manuscript. This work was partially supported by Grants-in-Aid for Scientific Research (C) (H.K., 19K09988) from JSPS KAKENHI (, The Eye Research Foundation for the Aged (ERFA, H.K.), Charitable Trust Fund for Ophthalmic Research in Commemoration of Santen Pharmaceutical's Founder (H.K.), Bayer Retina Award Foundation (H.K.), and Ichihara International Scholarship Foundation (H.K.).

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Correspondence to Hiroki Kaneko.

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H. Kaneko, Honorarium for Lecturing (AMO, HOYA); N. Hirata, None; H. Shimizu, None; K. Kataoka, Honoraria for lecturing (Novartis, Bayer, Santen, Senju); N. Nonobe, Honoraria for lecturing (Novartis), Grant (Bayer); K. Mokuno, None; H. Terasaki, Grant, Honoraria for lecturing (Otsuka, Kowa, Santen, Senju, Alcon, Novartis, Bayer, Pfizer, Wakamoto, HOYA), Grant, Consultant fee (Nidek), Honoraria for lecturing (ZEISS, Nitten, Mitsubishi Tanabe, AbbVie, Nikon, Sanofi), Grant (TOMEY, AMO, Eisai), Consultant fee (Daiich-Sankyo).

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Corresponding Author: Hiroki Kaneko

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Kaneko, H., Hirata, N., Shimizu, H. et al. Effect of internal limiting membrane peeling on visual field sensitivity in eyes with epiretinal membrane accompanied by glaucoma with hemifield defect and myopia. Jpn J Ophthalmol 65, 380–387 (2021).

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  • Epiretinal membrane
  • ILM peeling
  • Visual field sensitivity
  • Glaucoma with hemifield defect
  • Myopia